The Journal of Practical Medicine >
Clinical efficacy of concurrent chemoradiotherapy followed by sequential sintilimab immunotherapy in elderly patients with locally advanced esophageal cancer
Received date: 2024-09-25
Online published: 2025-02-19
Objective To investigate the safety and efficacy of Tigio capsules combined with intensity-modulated radiation therapy （IMRT）， followed by sequential sintilimab immunotherapy in elderly patients with locally advanced esophageal cancer. Methods From December 2020 to December 2023， 96 elderly patients with locally advanced esophageal cancer treated in Wuxi People's Hospital and Suzhou Hospital affiliated to Nanjing Medical University were selected. Using a random number table method， patients were divided into reference group （n = 48） and combination group （n = 48）. The reference group received concurrent chemoradiotherapy， while the combination group received sequential sintilimab immunotherapy combined with concurrent chemoradiotherapy. The clinical efficacy， changes in tumor markers （CEA， CA199， AFP， CYFRA21-1）， immune levels （CD4+， CD8+， CD16+ CD56+ NK）， quality of life （QLICP-ES）， and the incidence of radiation esophagitis， and immune pneumonitis， and other toxic effects were analyzed. Results After three months of treatment， the combination group showed higher ORR and DCR than the reference group （P < 0.05）. Levels of CEA， CA199， AFP， and CYFRA21-1 were lower in the combination group， whereas CD4+， CD16+ CD56+ NK levels were higher （P < 0.05）. Additionally， common and esophageal cancer-specific scores of the Quality of Life Instruments for Cancer Patients-Esophagus Cancer（QLICP-ES） were lower in the combination group （P < 0.05）. The incidence of radiation esophagitis， and immune pneumonitis， and related toxic effects showed no significant difference between the two groups （P > 0.05）. Conclusion Concurrent chemoradiotherapy followed by sequential sintilimab immunotherapy significantly improves clinical efficacy in elderly patients with locally advanced esophageal cancer and does not increase significant treatment-related toxicity. This approach enhances patients' immune function and is worthy of further clinical application.
Hao WANG , Xiaoyi LU , Wenjie. WANG . Clinical efficacy of concurrent chemoradiotherapy followed by sequential sintilimab immunotherapy in elderly patients with locally advanced esophageal cancer[J]. The Journal of Practical Medicine, 2025 , 41(3) : 365 -370 . DOI: 10.3969/j.issn.1006-5725.2025.03.009
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